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Monthly Archives: March 2015

Imagine that this Easter, the guest speaker at your church stands up from the pulpit and calmly mentions during the sermon that Jesus wasn’t really buried in a tomb, but was kept by his disciples in a house until he recovered enough from his wounds to go on his merry way.

What would you think of that speaker? Would you smile and nod, or even shout an ‘amen!’, buy their book, and encourage your pastor that they should be invited back again?

One would hope that there would be a polite but resounding outcry. Even if the rest of the message was perfect, you wouldn’t want someone to come back to your pulpit if they couldn’t get the basics of their subject right, even if they were considered a popular speaker or self-declared expert.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. Dr Leaf preaches every day from both physical pulpits all over the globe, and a virtual pulpit through the power of Instagram and Facebook.

Dr Leaf used her position of social media prominence today to share this little jewel, “The brain cannot change itself; you, with your love power and sound mind, change your brain.”

Um … that’s not true … at all … in any way.

For a start, the most prolific period for brain development is actually pre-birth, and then the first year of life. But foetal brains don’t have their own thoughts. It’s not like the movie “Look Who’s Talking” inside the average uterus. The brain of an unborn baby is growing and changing at an exponential rate without any thoughts to guide them [1].

Number of synapses per constant volume of tissue as a function of pre- and postnatal age. (Stiles, J. and Jernigan, T.L., The basics of brain development. Neuropsychol Rev, 2010. 20(4): 327-48 doi: 10.1007/s11065-010-9148-4)

In our adult years, our brain still continues to develop. But that development isn’t dependant on our thought life. Significant consolidation of our brain’s neural pathways occur when we’re asleep [2], but our thought life isn’t active during sleep.

Indeed, real cognitive neuroscientists have shown that our stream of thought is simply a tiny fraction of our overall neural activity, a conscious glimpse of the brains overall function [3-5]. So you don’t change your brain at all. “You” can’t, because it’s your brain’s directed activity which causes the growth of new synaptic branches to support it, all of which is subconscious.

Therefore, suggesting that our brain can only change with our conscious control is patently false, and so clearly against the most fundamental principles of neuroscience that such a claim is the neuroscientific equivalent of saying that Jesus didn’t die on the cross, he just swooned.

Dr Leaf has committed scientific heresy.

At this point, supporters of Dr Leaf often suggest that she wasn’t speaking literally, but metaphorically. She didn’t really mean that the brain can’t change itself, just that our choices are really important.

Somehow I doubt that. Dr Leaf wasn’t being metaphorical when she claimed that her patients in her research projects grew their intelligence when they “applied their minds”:
“Now with a traumatic brain injury, basically IQ generally goes down around twenty points because of the kind of damage with traumatic brain injury. Well her IQ was 100 before the accident, it was 120 after the accident. So here with holes in her brain, and brain damage, she changed … she actually increased her intelligence. Now I’m pretty convinced at this stage, cause I’ve been working … besides her I’ve been working with lots and lots of other patients, seeing the same thing, when these students applied their mind, their brain was changing, their academic results were changing.” [6]

Dr Leaf believes that your mind can literally change your brain. It was the subject of her entire TEDx talk in February.

It sounds innocent enough until you consider the broader implications of this way of thinking – those with brain damage haven’t recovered fully because they just haven’t applied their minds enough. The same for those with learning disabilities or autism, ADHD, Downs syndrome, cerebral palsy, dyslexia, or any other neurological disorder … because you only need to “apply your minds” to change your brain. “You have a powerful mind. You have a sound mind. You have a mind that is able to … to achieve what you’re dreams are. You are as intelligent as you want to be.” [6]

Or, in other words, don’t blame it on your brain if you’re intellectually disabled, mentally ill, or vacuous. You simply haven’t applied your brain well enough. Stop sitting around and think better.

As a church, we can, and should, be doing a lot better for those amongst us who suffer from neurological and mental disorders. It starts by being more judicious with who is allowed at that privileged position of the pulpit. We need to be eliminating scientific heresy from the pulpit, not clapping and shouting ‘amen!’

On the 4th of February 2015, Dr Caroline Leaf gave her debut TED presentation, at TEDx Oakes Christian School, California.

Most TED watchers wouldn’t have heard of her before, but Caroline Leaf is a well-known name in western Christendom. She has spoken from pulpits on every continent. She’s authored one of the best selling books in the Christian market and has her own TV show on cable in the US. She’s followed by more than one hundred thousand people on Facebook, and she’s even run her own conference, with another in the pipeline. She’s a mega-star in the Christian world.

So who is this woman with the stiletto-heels and slick presentation? What was her training and background? How did she make it to the TEDx stage?

This aim of this post is to provide some context and background for those in the TED universe who have seen Dr Leaf’s TEDx presentation, and want some more information in assessing her TEDx debut, and indeed, the global Caroline Leaf phenomenon.

This review will be in four main parts: first I will give some basic information on Dr Leaf, I will compare Dr Leaf’s claims in her TEDx presentation to her published research results and some basic neuroscience, and lastly I’ll outline Dr Leaf’s general work and it’s accuracy compared to current science.

WHO IS DR LEAF?

Dr Caroline Leaf was born and raised in South Africa, where she completed her school education and went on to attain the following degrees:

Bachelors of Science (Logopaedics) – University of Cape Town 1985

Masters in Audiology and Speech Pathology – University of Pretoria 1990

The journal happened to be edited by her supervisor and co-author, Dr Brenda Louw (see http://www.debunkingdrleaf.com/goodies), though I’m sure the selection of her articles for this journal was purely on merit.

Dr Leaf states on a number of occasions that she is a “cognitive neuroscientist”, and “a scientific and Biblical expert in the power of the human mind”.

This is despite the fact that Dr Leaf:

does not have formal qualifications in neuroscience,

has not worked at a university as a neuroscientist,

has not worked in any neuroscience research labs,

has not published any papers in neuroscience journals, and

has not had any formal theological training.

Given the weight of evidence, Dr Leaf would be better described as an academic speech pathologist and lay preacher rather than a cognitive neuroscientist.

DR LEAF’S RESEARCH RESULTS

Throughout her TEDx presentation, Dr Leaf repeatedly made reference to the results of her own research, suggesting that her pioneering work resulted in radically improved outcomes for the students involved in her research, and that her work with students one-on-one and through teacher education profoundly changed the learning of every student in her various programs.

For example, she said, “Well her IQ was 100 before the accident, it was 120 after the accident. So here with holes in her brain, and brain damage, she changed … she actually increased her intelligence. Now I’m pretty convinced at this stage, cause I’ve been working … besides her I’ve been working with lots and lots of other patients, seeing the same thing, when these students applied their mind, their brain was changing, their academic results were changing.”

Later she stated, “I wasn’t sure if this was going to have the same impact cause until this point I’d been working one on one. Well I’m happy to tell you that we had the same kind of results … The minute that the teachers actually started applying the techniques, we altered the trend significantly.”

And also, “I stand up here saying this with conviction because I have seen this over and over and over in so many different circumstances … in this country I worked in Dallas for three years in charter schools, and we found the same thing happening.”

However, her published results differ significantly from her claims.

The first research that Dr Leaf spoke of was of the sixteen-year-old girl who was the victim of a motor vehicle accident. This particular girl was Dr Leaf’s prime patient. The case study of this patient was presented in Dr Leaf’s unpublished Masters thesis, and was discussed in more detail in Dr Leaf’s paper, “Mind-Mapping approach (MMA): a culture and language “free” technique” [1], though it should be noted that no statistics were published in this paper, and on the third page of the article, Dr Leaf admitted that the result could actually have been spontaneous recovery rather than her own intervention.

Dr Leaf did further work within a number of schools for her PhD research. Dr Leaf compared the academic results for three schools for the years 1991 and 1992 to the results for 1993, during which she introduced her mind mapping approach (MMA). Generally, the results for 1993 were better than the results for 1992, which seems to indicate that Dr Leaf’s MMA training was effective. However, the results from 1991 to 1992 were already improving without her input [2: p182]. The difference in average marks between 1991 and 1992 was 1.76%, while the difference between 1992 and 1993 (the introduction of Dr Leaf’s MMA) was only 2.19%. If Dr Leaf’s program really was the cause of that improvement, then her program only resulted in a 0.43% improvement on average.

I have reproduced Dr Leaf’s original graph of the average overall results obtained in her PhD study. While Dr Leaf’s original graph makes her data look spectacular, when appropriately rescaled, the data looks quite ordinary.

At best, Dr Leaf’s program gave the already positive momentum of the students a gentle nudge.

However, it should be noted that her program may have also hindered some students. Dr Leaf notes in her analysis: “The results obtained indicate that in general the academic trend in the three primary remedial schools was altered with the introduction of the MMA methods in 1993. Furthermore, it appears that the most positive response occurred in phase one (grades 1 and 2, standard 1). A positive response also occurred in phase two (standards 2-4) but this change was just outside the significance level. Phase three (standard 5), by contrast, experienced negative effects with the introduction of the MMA methods.” [2: p181]

So to summarise, according to Dr Leaf’s own data, there was no clear benefit derived from her MMA program.

Dr Leaf then discussed her work in a number of charter schools that she performed in Dallas. This was part of testing of a program called the Switch On Your Brain 5-step learning process.

Dr Leaf claims that, “The Switch On Your Brain with the 5-Step Learning Process® was assessed in a group of charter schools in the Dallas. The results showed that the students’ thinking, understanding and knowledge improved across the board. It was concluded that The Switch On Your Brain with the 5-Step Learning Process® positively changed the way the students and teachers thought and approached learning.” http://drleaf.com/about/dr-leafs-research/

However, there has been no independent research into Dr Leaf’s Switch On Your Brain learning program or even the Geodesic Information Processing Theory, the theory Dr Leaf devised and on which the Switch On Your Brain program is based.

Dr Leaf published her own internal research into the program on her website. The project was a two year program involving teachers and students at a group of four schools in the Advantage Academy group in Dallas, Texas. This involved working with more than 150 teachers and 2000 students.

Despite her glowing self-assessment, Dr Leaf’s own published numbers suggest that the program is ineffective, or quite possibly a hindrance. For example, the graph below demonstrates the qualitative analysis of “content mastery” (which the paper describes as a combination of knowledge and understanding) for reading across all grades from 3rd to 12th, compared with the results from the previous year before the Switch On Your Brain was implemented. Dr Leaf omits a basic statistical analysis, but just by looking at the similarity of the scores, these results are more likely to be a chance effect, except for the 12th grade, where the previous cohort of students increased dramatically, where as the Switch On Your Brain cohort got slightly worse.

Rather than blame her program, Dr Leaf simply shifts the blame to the teachers: “The few cases where we see drops can be linked to teacher knowledge, attitude and skills and is diagnostic.”

The ineffectiveness of Dr Leaf’s program may be for many reasons, but I believe one is that it is built on a theory that relies on mind-mapping. Dr Leaf renamed her version of mind-mapping “The Metacog”, though it’s clear from her early academic work [1] that the Metacog and the Geodesic Information Processing Model [3] were based on the work of Tony Buzan. Buzan’s concept of mind-mapping has been used across multiple professional fields [4] and remains a valuable resource for brainstorming or gathering thoughts in a visual way. However, modern research (including a controlled trial within a primary school classroom environment) shows that mind mapping is a poor tool for learning [5-8].

DR LEAF’S IRONIC INSPIRATIONS

Dr Leaf openly contradicts herself throughout her presentation, failing to realise that the stories she shared of her own patients disproved her vacuous inspirational memes.

Our biology affects each and every one of us. Our mind is a function of our brain. Our mind is to our brain as our breath is to our lungs. Put simply, without our brain, we would have no thoughts. If the structure and function of specific networks in our brains are altered, this changes our thinking. This is confirmed in everyday life – when someone suffers a brain injury or a stroke and they sustain damage to their brain, they suddenly lose the function of some, or all of their mind or body. Trans-cranial Magnetic Stimulation, Trans-cranial Direct Current Stimulation, metabolic states, prescription medications, illicit drugs, or everyday drugs like caffeine or alcohol have all been proven to change the subjects mental state through changes to the function of their brain. Any suggestion that our brain does not control our mind is simply ludicrous.

Clearly then our biology does control our psychology. Real cognitive neuroscientists have shown that our stream of thought is simply a tiny fraction of our overall neural activity, a conscious glimpse of the brains overall function [9-11], like the tachometer is for the engine in your car. Thus, our mind does not change our brain at all. Rather, it is our brain’s directed activity causing the growth of new synaptic branches to support it, something which the brain does without the function of conscious thought from the time when we were embryos.

Dr Leaf actually confirms this fact through her stories of her brain injured patients. After all, if “the mind is separate from the brain but influencing the brain”, then how could those victims of acquired brain injury lose cognitive function after their injury? If it were true that “each and every one of us is not a victim of our biology. We are a victor over and above our biology. We control our brain, our brain does not control us”, then how could those people with damage to their brains from strokes suddenly lose function?

The fact that Dr Leaf’s patients lost their mental or cognitive function because of damage to their brains directly contradicts her insistence that our brain and our mind are separate, and that our brain does not control our mind.

FUNDAMENTALS OF DR LEAF’S OTHER TEACHING

Considered altogether, Dr Leaf’s teaching boils down to a few fundamentals;* Thought is the main driving force that controls every other aspect of our lives (and our physical world).* We have full control over our thoughts.
* Thought causes stress.
* Stress is directly responsible for nearly all serious physical and mental illness.
* Therefore thought causes the vast majority of human disease, making thoughts toxic, and
* If toxic thoughts cause disease, “detoxing” thoughts will cure or prevent disease.

On first inspection, each individual postulate doesn’t seem so bad. However, when fully considered and taken to their natural conclusions, they veer into conjecture and pseudoscience, as evidenced by Dr Leaf’s published works and public appearances.

For example, Dr Leaf states in her books:

“Thoughts influence every decision, word, action and physical reaction we make.” [12: p13] “Our mind is designed to control the body, of which the brain is a part, not the other way around. Matter does not control us; we control matter through our thinking and choosing.” [13: p33] “DNA actually changes shape according to our thoughts.” [13: p35]

On Facebook and in interviews, this translates to:

“Our genetic makeup fluctuates by the minute based on what we are thinking and choosing.” 27/9/2014“The toxic thoughts in our minds become physical baggage in our brain, which literally cause brain damage.” 5/12/2014, 27/10/2014 and 7/10/2014“Your mind will adjust your body’s biology and behaviour to fit with your beliefs.” 21/6/2014

“SID ROTH: But when you told me that we could change our genes I wish every doctor in the world would understand this cutting edge research because, you know, you go to a doctor and say your cholesterol was high, and they say, well, exercise, change your diet, but it could be your genes and there’s nothing you can do, so take this medicine that will have a zillion side effects. But you say, according to the latest brain research, if you follow what Jesus said you can change your genes. That’s just so amazing.DR. LEAF: I know. It is phenomenal. If you think of it, it’s logical too, Sid …”http://youtu.be/Uhbt_XOZTdA?t=50s. Full transcript: http://donate.sidroth.org//site/DocServer/IS571Transcript_Leaf.pdf?docID=2941

Dr Leaf draws her erroneous conclusions from the poor interpretation of poor evidence. For example, one of Dr Leaf’s favourite factoids is her statement that “Research shows that 75 to 98 percent of mental, physical and behavioral illness comes from one’s thought life.” [13: p33] Dr Leaf’s sources for this statement include, among others, an article that not only doesn’t mention the figure she attributes to it, but also directly contradicts her fundamental premise [14], and the misleading paraphrasing of an already dubious quote from a pseudoscientific author [15].

Dr Leaf also has a number of pet theories which betray her preference for pseudoscience, the main one being her assertion that the heart is actually a mini-brain that has dedicated cognitive functions. For example, in her books, she says,

“Your heart is in constant communication with your brain and the rest of your body, checking the accuracy and integrity of your thought life. As you are about to make a decision, your heart pops in a quiet word of advice, well worth listening to, because when you listen to your heart, it secretes the ANF hormone that gives you a feeling of peace.” [12: p62, 13: p127]

Dr Leaf directly quotes the work of an organisation called HeartMath for her evidence that the heart acts as a mini-brain. Dr Leaf, via Heartmath, states that:
> The heart has a network of 40,000 neurons within it, called sensory neurites, which detect circulating hormones, neurochemicals, and sense heart rate and blood pressure,
> The heart secretes “neurotransmitters” and other hormones, which have an effect on the brain, such as atrial natriuretic factor, and oxytocin,
> The heart communicates with the brain and the rest of the body through neurological, biophysical, biochemical and “energetic” (ie: electromagnetic) means [16, 17].

HeartMath clarifies, “The heart’s brain is an intricate network of several types of neurons, neurotransmitters, proteins and support cells like those found in the brain proper. Its elaborate circuitry enables it to act independently of the cranial brain – to learn, remember, and even feel and sense.” [16]

So the “evidence” looks plausible on the surface, but absurd when considered in a broader biological context. For example, my heart may have 40,000 neurons, many of which are sensitive to circulating hormones, neurochemicals and which sense and feel, but then again, so does my rectum. Does my rectum have a mini-brain as well? Clearly not. The only brain you have is the one in your cranium. We do not think with our heart, our rectum, or any other body part.

The opening question from Dr Leaf’s presentation at the 2015 TEDx Oaks Christian School was, “Can the mind change the brain?”

Clearly the answer is: “No, it can not.”

Others are welcome to disagree, but in my humble opinion, I suggest that Dr Leaf is a pseudoscientist, and that her appearance on the TEDx stage is not based on scientific acumen, but on popularity and reputation, which in turn, is based on slick self-promotion and an availability cascade (a self-reinforcing process by which an idea gains plausibility through repetition).

Dr Leaf’s ideas may have popular approval, but TEDx is a vehicle for ideas worth spreading, not ideas that are popular. According to its guidelines, TEDx requests that pseudoscience be avoided, specifically stating, “TED and TEDx are platforms for showcasing and explaining genuine advances in science … Speakers should avoid the misuse of scientific language to make unsubstantiated claims.” (http://www.ted.com/participate/organize-a-local-tedx-event/before-you-start/tedx-rules)

Dr Leaf’s claims, that her research has significantly changed the lives of the students who were blessed to receive it, is simply not born out by any of her own published data – from her original case study through to her MMA project and her Switch On Your Brain program. Whatever the underlying reason … whether its hubris, naivety, or denial that’s driving her continued promotion of her own programs … her claims are baseless, and therefore an argument can be made that she breached the TEDx guidelines in presenting them, and indeed, she should never have been invited to deliver them from a TEDx stage in the first place.

The theme for the 2015 TEDx Oaks Christian School event was “Ridiculous”. I would argue that it was ridiculous that Dr Leaf promoted her research as life changing when in reality, it’s not much better than a placebo. It was ridiculous that Dr Leaf would share stories of the changes to the cognitive functioning of her patients from their brain damage and then claim that the brain does not influence the mind. It seems that Dr Leaf’s presentation certainly fitted their theme, although probably not in the way they intended. Lets hope for their sake that their “ridiculous” decision doesn’t effect their ability to host future TEDx presentations.

I was entertained somewhat by Dr Leaf’s latest Facebook post this evening. In it, there was a pairing of water and a pot-plant, and sugary drinks and a child, with the words, “If you give this (water) to your plants? Why give this (sugary beverages) to your children.”

Without looking too closely, one might think that Dr Leaf was making a good point. Water is good, and sugar is bad, right?

With just a little more thinking, one can see that the metaphor is pretty weak. Plants aren’t children. Following the same logic of the metaphor, I should feed my children manure instead of food, since it’s clearly good enough for the pot-plant.

What is worrying about this post is Dr Leaf’s linking of diet with our Christian morals. Dr Leaf tries to link the concept of drinking water to the worship of God, because your body is a temple, and “Whether you eat or drink, or whatever you do, do it all for the glory of God.” (1 Corinthians 10:31). By logical extrapolation, Dr Leaf is therefore saying that drinking Coke is dishonouring God and the temple he gave for you. If you drink Coke, then you’re a bad Christian.

Though that’s really only Dr Leaf’s interpretation, because the scripture that she quotes isn’t talking about the composition of the food you eat but about it’s relationship to the sacrifice to idols. As far as I was aware, Coke isn’t used in any worship of idols before it’s bottled and distributed. So really, I don’t think whether you drink coke or other sodas will have any bearing on your relationship with God.

Perhaps Dr Leaf would have better spent her time outlining the studies that back up her overly dramatic statement “that sugary drinks like soda and processed orange juice can cause neurochemical havoc in your brain” rather than just hoping people will take her at her word.

Lets be real … no one in their right mind is encouraging children to have more sugar, mainly because of the excess calories, and not the hysterical notion of “neurochemical havoc”. Dr Leaf’s trying to get it right, but her poor metaphor, and the linking of ones diet to ones honouring of God probably went a step too far.

It would be nice if Dr Leaf could reexamine her knowledge of nutritional science and the scriptures that she uses so that she doesn’t weaken her credibility with such posts in the future.

ADHD is always a popular topic … and an apoplexic topic. Any mention of ADHD seems to induce everyone within ear-shot to uncontrollably expectorate their half-baked opinion on the subject, like the Tourette’s syndrome of ignorance.

ADHD is the new AIDS. There is so much misinformation and discrimination surrounding ADHD in our modern enlightened society that the stigma is worse than the actual illness, which really says something about how badly ADHD is treated in our communities.

One of the cruellest aspects of the cultural mismanagement of ADHD is the fact that it maligns the sufferers while simultaneously isolating them from much needed support. Saying that children with ADHD should just behave themselves, or parents of children with ADHD should just have better parenting skills is victim blaming at its worst.

In order to counter the prevalent ignorance of ADHD, even just a little, I want to give a crash course on the science so that at least somewhere on the searchable web, there is a counterbalance to the thousands of misinformed arm-chair ‘experts’ whose only experience with ADHD is reading the misguided perspectives of other so-called ‘experts’.

ADHD stands for Attention Deficit Hyperactivity Disorder.

The current formal definition that must be matched to have a diagnosis of ADHD is:

Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:* Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.* Often has trouble holding attention on tasks or play activities.* Often does not seem to listen when spoken to directly.* Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).* Often has trouble organizing tasks and activities.* Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).* Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).* Is often easily distracted* Is often forgetful in daily activities.

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:* Often fidgets with or taps hands or feet, or squirms in seat.* Often leaves seat in situations when remaining seated is expected.* Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).* Often unable to play or take part in leisure activities quietly.* Is often “on the go” acting as if “driven by a motor”.* Often talks excessively.* Often blurts out an answer before a question has been completed.* Often has trouble waiting his/her turn.* Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:– Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.– Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).– There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.– The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
– The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder.(http://www.cdc.gov/ncbddd/adhd/diagnosis.html)

In Australia, ADHD cannot be formally diagnosed by anyone other than a paediatrician or a psychiatrist. So even as an experienced GP, I can’t officially diagnose it. The school counsellor or local naturopath can’t diagnose it. You can’t just pluck it out of the air. The diagnosis can only come from a medical specialist with at least a decade of university level training.

The official prevalence rate of ADHD (the number of people with a current diagnosis) is only 5%. According to some US based community surveys, nearly a half of those children are not on medication for it (http://www.cdc.gov/ncbddd/adhd/data.html). So much for Ritalin being overprescribed.

ADHD is a predominantly genetic disorder which leads to specific structural deficiencies in the brain. Children with ADHD have a significant global reduction in the volume of grey matter, most prominently in a part of the brain called the right lentiform nucleus. These changes usually improve with age and improve with stimulant medication. There is also evidence of changes to the shape and size of other brain structures such as the amygdala and the thalamus (areas of the brain integral to sensory and emotional processing). Early evidence also exists which suggests changes in the white matter pathways connecting a number of critical brain regions. Studies investigating brain development have estimated that the frontal lobe development of ADHD children lags that of normal children by an average of about three years.

These changes in the brain are not caused by the child’s behaviour, since other studies have shown the same changes in the brains of unaffected first degree relatives (brothers or sisters), just to a milder degree.

Modern functional imaging techniques show that the brains of children with ADHD have abnormally low functioning in most of the brain structures related to attention and planning (numerous areas of the frontal cortex as well as the basal ganglia, thalamus and parietal cortices). At the same time, there is extra activity in portions of the brain related to the Default Mode Network (the day-dreaming part of your brain). So children with ADHD have brains in which the ‘day-dreaming’ network activity persists into, or emerges during, periods of task-related activity. This takes processing power away from the competing task-specific processing causing a deficit in performance. Studies show that Ritalin normalises this dysfunction.

The best evidence suggests that dopamine is the main neurotransmitter involved in ADHD. Other neurotransmitters are likely to be involved but the evidence is still being confirmed. Medications like Ritalin improve ADHD symptoms by increasing the amount of dopamine that the nerve cells have access to, improving the clarity of the signal between them.

Underlying all of these neural changes are genetics. While there have been no specific genes discovered in research thus far, twin studies have demonstrated a heritability of ADHD of up to 76%. The most significant environmental factors that are responsible for the remainder of the influence on ADHD are not nutritional factors such as sugar or food additives, but are low birth weight/prematurity and exposure to smoking during pregnancy.

Are there any better treatments for ADHD other than stimulants like Ritalin? Other non-stimulant medications are available although at this stage, Ritalin and Dexamphetamine still out-perform them. Cognitive therapies may mimic some of the brain changes of Ritalin but it is not clear whether the effectiveness of cognitive therapies are equal to or better than the stimulant medications. What is clear is that Ritalin doesn’t lead to a euphoric state (a “drug high”) when given orally. So children can not get addicted to Ritalin when used responsibly.

In summary, ADHD exists. It’s caused by the interaction of a number of genes and some environmental factors such as those related to prematurity, low birth weight and maternal smoking, which alter the growth and development of the brain, specifically the grey matter of the frontal cortex, the basal ganglia and thalamus, and the pathways which connect them. These structural changes cause the day-dreaming part of the brain to be more active and the attention and planning parts of the brain to be less active.

ADHD is not caused by food additives or sugar. There is no evidence that autoimmunity plays a significant part. Forcing your child to consume bone broth or stop eating gluten will not cure them.

ADHD is not caused by bad parenting. Ritalin is not evil. Medications like Ritalin and Dexamphetamine have been shown to improve the functioning of children with ADHD and improve their underlying neurological deficits.

It’s time to cut the crap. Our culture needs to stop victimising the child with ADHD and their parents, who already suffer enough from the ADHD without ignorant busy-bodies and self-titled experts chiming in and making their suffering even more pronounced. It’s time to stop judging those who choose the best for their child by medicating them, who do so in spite of the unfair and ill-informed criticism of everyone from their mother-in-law to the milkman when they do. It’s time to remove the stigma from one of the most common psychiatric disorders of childhood so that every child has an equal chance of growing into an adult that can realise their full potential.